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Postgrad Med J. Jun 2005; 81(956): 358–366.
PMCID: PMC1743285

Pathophysiology of dyslipidaemia in the metabolic syndrome

Abstract

The insulin resistance/metabolic syndrome is characterised by the variable coexistence of hyperinsulinaemia, obesity, dyslipidaemia, and hypertension. The pathogenesis of the syndrome has multiple origins, but obesity and sedentary lifestyle coupled with diet and still largely unknown genetic factors clearly interact to produce the syndrome. Dyslipidaemia, the hallmark of the metabolic syndrome, includes increased flux of free fatty acids, raised triglycerides, apolipoprotein B, and small dense low density lipoprotein, and decreased high density lipoprotein cholesterol. The widely prevalent nature of the metabolic syndrome emphasises the importance of its diagnosis and treatment. This review analyses the clinical and dynamic features of this syndrome in the aspect of dyslipidaemia and its management.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Reilly Muredach P, Rader Daniel J. The metabolic syndrome: more than the sum of its parts? Circulation. 2003 Sep 30;108(13):1546–1551. [PubMed]
  • Festa A, D'Agostino R, Jr, Howard G, Mykkänen L, Tracy RP, Haffner SM. Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation. 2000 Jul 4;102(1):42–47. [PubMed]
  • Messerli Adrian W, Seshadri Niranjan, Pearce Gregory L, Sachar Ravish, Hoogwerf Byron J, Sprecher Dennis L. Relation of albumin/creatinine ratio to C-reactive protein and to the metabolic syndrome. Am J Cardiol. 2003 Sep 1;92(5):610–612. [PubMed]
  • Väisänen S, Baumstark MW, Penttilä I, Bouchard C, Halonen P, Rankinen T, Berg A, Rauramaa R. Small, dense LDL particle concentration correlates with plasminogen activator inhibitor type-1 (PAI-1) activity. Thromb Haemost. 1997 Dec;78(6):1495–1499. [PubMed]
  • Corella Dolores, Ordovas Jose M. The metabolic syndrome: a crossroad for genotype-phenotype associations in atherosclerosis. Curr Atheroscler Rep. 2004 May;6(3):186–196. [PubMed]
  • Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988 Dec;37(12):1595–1607. [PubMed]
  • Semenkovich Clay F. Fatty acid metabolism and vascular disease. Trends Cardiovasc Med. 2004 Feb;14(2):72–76. [PubMed]
  • Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998 Jul;15(7):539–553. [PubMed]
  • Ford Earl S, Giles Wayne H, Dietz William H. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA. 2002 Jan 16;287(3):356–359. [PubMed]
  • Lakka H-M, Lakka TA, Tuomilehto J, Salonen JT. Abdominal obesity is associated with increased risk of acute coronary events in men. Eur Heart J. 2002 May;23(9):706–713. [PubMed]
  • Hsia Judith, Bittner Vera, Tripputi Mark, Howard Barbara V. Metabolic syndrome and coronary angiographic disease progression: the Women's Angiographic Vitamin & Estrogen trial. Am Heart J. 2003 Sep;146(3):439–445. [PubMed]
  • Balkau Beverley, Charles Marie-Aline, Drivsholm Thomas, Borch-Johnsen Knut, Wareham Nick, Yudkin John S, Morris Richard, Zavaroni Ivana, van Dam Rob, Feskins Edith, et al. Frequency of the WHO metabolic syndrome in European cohorts, and an alternative definition of an insulin resistance syndrome. Diabetes Metab. 2002 Nov;28(5):364–376. [PubMed]
  • Isomaa B, Almgren P, Tuomi T, Forsén B, Lahti K, Nissén M, Taskinen MR, Groop L. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001 Apr;24(4):683–689. [PubMed]
  • Meigs James B, Wilson Peter W F, Nathan David M, D'Agostino Ralph B, Sr, Williams Ken, Haffner Steven M. Prevalence and characteristics of the metabolic syndrome in the San Antonio Heart and Framingham Offspring Studies. Diabetes. 2003 Aug;52(8):2160–2167. [PubMed]
  • Ravussin E, Valencia ME, Esparza J, Bennett PH, Schulz LO. Effects of a traditional lifestyle on obesity in Pima Indians. Diabetes Care. 1994 Sep;17(9):1067–1074. [PubMed]
  • Clement Karine, Boutin Philippe, Froguel Philippe. Genetics of obesity. Am J Pharmacogenomics. 2002;2(3):177–187. [PubMed]
  • Matsuzawa Yuji, Funahashi Tohru, Kihara Shinji, Shimomura Iichiro. Adiponectin and metabolic syndrome. Arterioscler Thromb Vasc Biol. 2004 Jan;24(1):29–33. [PubMed]
  • Malczewska-Malec Małgorzata, Wybranska Iwona, Leszczynska-Golabek Iwona, Partyka Lukasz, Hartwich Jadwiga, Jabrocka Agata, Kiec-Wilk Beata, Kwasniak Małgorzata, Motyka Marcin, Dembinska-Kiec Aldona. Analysis of candidate genes in Polish families with obesity. Clin Chem Lab Med. 2004 May;42(5):487–493. [PubMed]
  • Merkel Martin, Eckel Robert H, Goldberg Ira J. Lipoprotein lipase: genetics, lipid uptake, and regulation. J Lipid Res. 2002 Dec;43(12):1997–2006. [PubMed]
  • van Dijk Ko Willems, Rensen Patrick C N, Voshol Peter J, Havekes Louis M. The role and mode of action of apolipoproteins CIII and AV: synergistic actors in triglyceride metabolism? Curr Opin Lipidol. 2004 Jun;15(3):239–246. [PubMed]
  • Ashavaid Tester F, Shalia Kavita K, Kondkar Altaf A, Todur Seema P, Nair Kappiareth G, Nair Sunita R. Gene polymorphism and coronary risk factors in Indian population. Clin Chem Lab Med. 2002 Oct;40(10):975–985. [PubMed]
  • Lee Kenny W J, Ayyobi Amir F, Frohlich Jiri J, Hill John S. APOA5 gene polymorphism modulates levels of triglyceride, HDL cholesterol and FERHDL but is not a risk factor for coronary artery disease. Atherosclerosis. 2004 Sep;176(1):165–172. [PubMed]
  • Morabia Alfredo, Ross Barbara M, Costanza Michael C, Cayanis Eftihia, Flaherty Maria Sol, Alvin Gabriela B, Das Kamna, James Richard, Yang An-Suei, Evagrafov Oleg, et al. Population-based study of SR-BI genetic variation and lipid profile. Atherosclerosis. 2004 Jul;175(1):159–168. [PubMed]
  • Wang Yutong, Kurdi-Haidar Buran, Oram John F. LXR-mediated activation of macrophage stearoyl-CoA desaturase generates unsaturated fatty acids that destabilize ABCA1. J Lipid Res. 2004 May;45(5):972–980. [PubMed]
  • Gudnason V, Kakko S, Nicaud V, Savolainen MJ, Kesäniemi YA, Tahvanainen E, Humphries S. Cholesteryl ester transfer protein gene effect on CETP activity and plasma high-density lipoprotein in European populations. The EARS Group. Eur J Clin Invest. 1999 Feb;29(2):116–128. [PubMed]
  • Sethi Amar Akhtar, Nordestgaard Børge Grønne, Tybjaerg-Hansen Anne. Angiotensinogen gene polymorphism, plasma angiotensinogen, and risk of hypertension and ischemic heart disease: a meta-analysis. Arterioscler Thromb Vasc Biol. 2003 Jul 1;23(7):1269–1275. [PubMed]
  • Ji Quihe, Ikegami Hiroshi, Fujisawa Tomomi, Kawabata Yumiko, Ono Masaya, Nishino Masanori, Ohishi Mitsuru, Katsuya Tomohiro, Rakugi Hiromi, Ogihara Toshio. A common polymorphism of uncoupling protein 2 gene is associated with hypertension. J Hypertens. 2004 Jan;22(1):97–102. [PubMed]
  • Wang Ji-Guang, Liu Lifang, Zagato Laura, Xie Jinxiang, Fagard Robert, Jin Kugen, Wang Jinxiang, Li Yan, Bianchi Giuseppe, Staessen Jan A, et al. Blood pressure in relation to three candidate genes in a Chinese population. J Hypertens. 2004 May;22(5):937–944. [PubMed]
  • Ginsberg HN, Huang LS. The insulin resistance syndrome: impact on lipoprotein metabolism and atherothrombosis. J Cardiovasc Risk. 2000 Oct;7(5):325–331. [PubMed]
  • Ninomiya John K, L'Italien Gilbert, Criqui Michael H, Whyte Joanna L, Gamst Anthony, Chen Roland S. Association of the metabolic syndrome with history of myocardial infarction and stroke in the Third National Health and Nutrition Examination Survey. Circulation. 2004 Jan 6;109(1):42–46. [PubMed]
  • Anderson Jeffrey L, Horne Benjamin D, Jones Heath U, Reyna Sandra P, Carlquist John F, Bair Tami L, Pearson Robert R, Lappé Donald L, Muhlestein Joseph B. Which features of the metabolic syndrome predict the prevalence and clinical outcomes of angiographic coronary artery disease? Cardiology. 2004;101(4):185–193. [PubMed]
  • Sacco RL, Benson RT, Kargman DE, Boden-Albala B, Tuck C, Lin IF, Cheng JF, Paik MC, Shea S, Berglund L. High-density lipoprotein cholesterol and ischemic stroke in the elderly: the Northern Manhattan Stroke Study. JAMA. 2001 Jun 6;285(21):2729–2735. [PubMed]
  • Trayhurn P, Beattie JH. Physiological role of adipose tissue: white adipose tissue as an endocrine and secretory organ. Proc Nutr Soc. 2001 Aug;60(3):329–339. [PubMed]
  • Haluzík M, Parízková J, Haluzík MM. Adiponectin and its role in the obesity-induced insulin resistance and related complications. Physiol Res. 2004;53(2):123–129. [PubMed]
  • Drayna D, Jarnagin AS, McLean J, Henzel W, Kohr W, Fielding C, Lawn R. Cloning and sequencing of human cholesteryl ester transfer protein cDNA. Nature. 1987 Jun 18;327(6123):632–634. [PubMed]
  • Morton RE. Cholesteryl ester transfer protein and its plasma regulator: lipid transfer inhibitor protein. Curr Opin Lipidol. 1999 Aug;10(4):321–327. [PubMed]
  • Arai T, Yamashita S, Hirano K, Sakai N, Kotani K, Fujioka S, Nozaki S, Keno Y, Yamane M, Shinohara E, et al. Increased plasma cholesteryl ester transfer protein in obese subjects. A possible mechanism for the reduction of serum HDL cholesterol levels in obesity. Arterioscler Thromb. 1994 Jul;14(7):1129–1136. [PubMed]
  • Gorter Petra M, Olijhoek Jobien K, van der Graaf Yolanda, Algra Ale, Rabelink Ton J, Visseren Frank L J. Prevalence of the metabolic syndrome in patients with coronary heart disease, cerebrovascular disease, peripheral arterial disease or abdominal aortic aneurysm. Atherosclerosis. 2004 Apr;173(2):363–369. [PubMed]
  • Lewis GF, Uffelman KD, Szeto LW, Weller B, Steiner G. Interaction between free fatty acids and insulin in the acute control of very low density lipoprotein production in humans. J Clin Invest. 1995 Jan;95(1):158–166. [PMC free article] [PubMed]
  • Prinsen Berthil H C M T, Romijn Johannes A, Bisschop Peter H, de Barse Martina M J, Barrett P Hugh R, Ackermans Mariëtte, Berger Ruud, Rabelink Ton J, de Sain-van der Velden Monique G M. Endogenous cholesterol synthesis is associated with VLDL-2 apoB-100 production in healthy humans. J Lipid Res. 2003 Jul;44(7):1341–1348. [PubMed]
  • Malmström R, Packard CJ, Watson TD, Rannikko S, Caslake M, Bedford D, Stewart P, Yki-Järvinen H, Shepherd J, Taskinen MR. Metabolic basis of hypotriglyceridemic effects of insulin in normal men. Arterioscler Thromb Vasc Biol. 1997 Jul;17(7):1454–1464. [PubMed]
  • Lewis GF, Uffelman KD, Szeto LW, Steiner G. Effects of acute hyperinsulinemia on VLDL triglyceride and VLDL apoB production in normal weight and obese individuals. Diabetes. 1993 Jun;42(6):833–842. [PubMed]
  • Goldstein Barry J. Insulin resistance: from benign to type 2 diabetes mellitus. Rev Cardiovasc Med. 2003;4 (Suppl 6):S3–10. [PubMed]
  • McFarlane SI, Banerji M, Sowers JR. Insulin resistance and cardiovascular disease. J Clin Endocrinol Metab. 2001 Feb;86(2):713–718. [PubMed]
  • Kwiterovich Peter O., Jr Clinical relevance of the biochemical, metabolic, and genetic factors that influence low-density lipoprotein heterogeneity. Am J Cardiol. 2002 Oct 17;90(8A):30i–47i. [PubMed]
  • Packard CJ, Demant T, Stewart JP, Bedford D, Caslake MJ, Schwertfeger G, Bedynek A, Shepherd J, Seidel D. Apolipoprotein B metabolism and the distribution of VLDL and LDL subfractions. J Lipid Res. 2000 Feb;41(2):305–318. [PubMed]
  • Ginsberg HN, Le NA, Goldberg IJ, Gibson JC, Rubinstein A, Wang-Iverson P, Norum R, Brown WV. Apolipoprotein B metabolism in subjects with deficiency of apolipoproteins CIII and AI. Evidence that apolipoprotein CIII inhibits catabolism of triglyceride-rich lipoproteins by lipoprotein lipase in vivo. J Clin Invest. 1986 Nov;78(5):1287–1295. [PMC free article] [PubMed]
  • Packard CJ. Triacylglycerol-rich lipoproteins and the generation of small, dense low-density lipoprotein. Biochem Soc Trans. 2003 Oct;31(Pt 5):1066–1069. [PubMed]
  • Lamarche B, Tchernof A, Mauriège P, Cantin B, Dagenais GR, Lupien PJ, Després JP. Fasting insulin and apolipoprotein B levels and low-density lipoprotein particle size as risk factors for ischemic heart disease. JAMA. 1998 Jun 24;279(24):1955–1961. [PubMed]
  • Chait A, Brazg RL, Tribble DL, Krauss RM. Susceptibility of small, dense, low-density lipoproteins to oxidative modification in subjects with the atherogenic lipoprotein phenotype, pattern B. Am J Med. 1993 Apr;94(4):350–356. [PubMed]
  • Kwiterovich PO, Jr, Coresh J, Smith HH, Bachorik PS, Derby CA, Pearson TA. Comparison of the plasma levels of apolipoproteins B and A-1, and other risk factors in men and women with premature coronary artery disease. Am J Cardiol. 1992 Apr 15;69(12):1015–1021. [PubMed]
  • Kwiterovich PO, Jr, Coresh J, Bachorik PS. Prevalence of hyperapobetalipoproteinemia and other lipoprotein phenotypes in men (aged < or = 50 years) and women (< or = 60 years) with coronary artery disease. Am J Cardiol. 1993 Mar 15;71(8):631–639. [PubMed]
  • Wilson Peter W F, Grundy Scott M. The metabolic syndrome: practical guide to origins and treatment: Part I. Circulation. 2003 Sep 23;108(12):1422–1424. [PubMed]
  • Rust S, Rosier M, Funke H, Real J, Amoura Z, Piette JC, Deleuze JF, Brewer HB, Duverger N, Denèfle P, et al. Tangier disease is caused by mutations in the gene encoding ATP-binding cassette transporter 1. Nat Genet. 1999 Aug;22(4):352–355. [PubMed]
  • Kolovou Genovefa D, Cokkinos Dennis V. Low serum levels of high-density lipoprotein cholesterol and hypolipidaemic treatment. Curr Med Res Opin. 2002;18(5):265–268. [PubMed]
  • Kolovou Genovefa D, Daskalova Deliana C, Petropoulos Ilias I, Anagnostopoulou Katherine K, Bilianou Helen I, Pilatis Nektarios D, Pavlidis Antonis N, Cokkinos Dennis V. Effect of baseline levels on response of high-density lipoprotein cholesterol to hypolipidemic treatment. Am J Cardiol. 2003 Dec 1;92(11):1339–1342. [PubMed]
  • Taira K, Hikita M, Kobayashi J, Bujo H, Takahashi K, Murano S, Morisaki N, Saito Y. Delayed post-prandial lipid metabolism in subjects with intra-abdominal visceral fat accumulation. Eur J Clin Invest. 1999 Apr;29(4):301–308. [PubMed]
  • Rebuffé-Scrive M, Lönnroth P, Mårin P, Wesslau C, Björntorp P, Smith U. Regional adipose tissue metabolism in men and postmenopausal women. Int J Obes. 1987;11(4):347–355. [PubMed]
  • Couillard C, Bergeron N, Prud'homme D, Bergeron J, Tremblay A, Bouchard C, Mauriège P, Després JP. Postprandial triglyceride response in visceral obesity in men. Diabetes. 1998 Jun;47(6):953–960. [PubMed]
  • Mazzone T, Foster D, Chait A. In vivo stimulation of low-density lipoprotein degradation by insulin. Diabetes. 1984 Apr;33(4):333–338. [PubMed]
  • Cummings MH, Watts GF, Umpleby AM, Hennessy TR, Kelly JM, Jackson NC, Sönksen PH. Acute hyperinsulinemia decreases the hepatic secretion of very-low-density lipoprotein apolipoprotein B-100 in NIDDM. Diabetes. 1995 Sep;44(9):1059–1065. [PubMed]
  • Cooper AD. Hepatic uptake of chylomicron remnants. J Lipid Res. 1997 Nov;38(11):2173–2192. [PubMed]
  • Thompson GR, Naoumova RP, Watts GF. Role of cholesterol in regulating apolipoprotein B secretion by the liver. J Lipid Res. 1996 Mar;37(3):439–447. [PubMed]
  • Patsch JR, Miesenböck G, Hopferwieser T, Mühlberger V, Knapp E, Dunn JK, Gotto AM, Jr, Patsch W. Relation of triglyceride metabolism and coronary artery disease. Studies in the postprandial state. Arterioscler Thromb. 1992 Nov;12(11):1336–1345. [PubMed]
  • Kolovou Genovefa D, Daskalova Deliana Ch, Iraklianou Stella A, Adamopoulou Evdokia N, Pilatis Nektarios D, Hatzigeorgiou Georgios C, Cokkinos Dennis V. Postprandial lipemia in hypertension. J Am Coll Nutr. 2003 Feb;22(1):80–87. [PubMed]
  • Kolovou GD, Anagnostopoulou KK, Pilatis ND, Iraklianou S, Hoursalas IS, Liberi S, Pavlidis AN, Dritsas A, Mikhailidis DP, Cokkinos DV. Heterozygote men with familial hypercholesterolaemia may have an abnormal triglyceride response post-prandially. Evidence for another predictor of vascular risk in familial hypercholesterolaemia. Int J Clin Pract. 2005 Mar;59(3):311–317. [PubMed]
  • Vinicor F. Is diabetes a public-health disorder? Diabetes Care. 1994 Jun;17 (Suppl 1):22–27. [PubMed]
  • Pinhas-Hamiel O, Dolan LM, Daniels SR, Standiford D, Khoury PR, Zeitler P. Increased incidence of non-insulin-dependent diabetes mellitus among adolescents. J Pediatr. 1996 May;128(5 Pt 1):608–615. [PubMed]
  • Boden G. Fatty acids and insulin resistance. Diabetes Care. 1996 Apr;19(4):394–395. [PubMed]
  • Haffner SM, Lehto S, Rönnemaa T, Pyörälä K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998 Jul 23;339(4):229–234. [PubMed]
  • Goldstein JL, Schrott HG, Hazzard WR, Bierman EL, Motulsky AG. Hyperlipidemia in coronary heart disease. II. Genetic analysis of lipid levels in 176 families and delineation of a new inherited disorder, combined hyperlipidemia. J Clin Invest. 1973 Jul;52(7):1544–1568. [PMC free article] [PubMed]
  • Rainwater DL, Mitchell BD, Mahaney MC, Haffner SM. Genetic relationship between measures of HDL phenotypes and insulin concentrations. Arterioscler Thromb Vasc Biol. 1997 Dec;17(12):3414–3419. [PubMed]
  • Sniderman AD, Castro Cabezas M, Ribalta J, Carmena R, de Bruin TWA, de Graaf J, Erkelens DW, Humphries SE, Masana L, Real JT, et al. A proposal to redefine familial combined hyperlipidaemia -- third workshop on FCHL held in Barcelona from 3 to 5 May 2001, during the scientific sessions of the European Society for Clinical Investigation. Eur J Clin Invest. 2002 Feb;32(2):71–73. [PubMed]
  • Jarvik GP, Brunzell JD, Austin MA, Krauss RM, Motulsky AG, Wijsman E. Genetic predictors of FCHL in four large pedigrees. Influence of ApoB level major locus predicted genotype and LDL subclass phenotype. Arterioscler Thromb. 1994 Nov;14(11):1687–1694. [PubMed]
  • Chan Dick C, Barrett Hugh P R, Watts Gerald F. Dyslipidemia in visceral obesity: mechanisms, implications, and therapy. Am J Cardiovasc Drugs. 2004;4(4):227–246. [PubMed]
  • Knopp RH, Walden CE, Retzlaff BM, McCann BS, Dowdy AA, Albers JJ, Gey GO, Cooper MN. Long-term cholesterol-lowering effects of 4 fat-restricted diets in hypercholesterolemic and combined hyperlipidemic men. The Dietary Alternatives Study. JAMA. 1997 Nov 12;278(18):1509–1515. [PubMed]
  • Sudhop Thomas, Lütjohann Dieter, Kodal Annette, Igel Michael, Tribble Diane L, Shah Sukrut, Perevozskaya Inna, von Bergmann Klaus. Inhibition of intestinal cholesterol absorption by ezetimibe in humans. Circulation. 2002 Oct 8;106(15):1943–1948. [PubMed]
  • Simonen P, Gylling H, Howard AN, Miettinen TA. Introducing a new component of the metabolic syndrome: low cholesterol absorption. Am J Clin Nutr. 2000 Jul;72(1):82–88. [PubMed]
  • Chan Dick C, Watts Gerald F, Barrett P Hugh R, O'Neill Frans H, Redgrave Trevor G, Thompson Gilbert R. Relationships between cholesterol homoeostasis and triacylglycerol-rich lipoprotein remnant metabolism in the metabolic syndrome. Clin Sci (Lond) 2003 Apr;104(4):383–388. [PubMed]
  • Downs JR, Clearfield M, Weis S, Whitney E, Shapiro DR, Beere PA, Langendorfer A, Stein EA, Kruyer W, Gotto AM., Jr Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA. 1998 May 27;279(20):1615–1622. [PubMed]
  • Keech Anthony, Colquhoun David, Best James, Kirby Adrienne, Simes R John, Hunt David, Hague Wendy, Beller Elaine, Arulchelvam Manjula, Baker Jennifer, et al. Secondary prevention of cardiovascular events with long-term pravastatin in patients with diabetes or impaired fasting glucose: results from the LIPID trial. Diabetes Care. 2003 Oct;26(10):2713–2721. [PubMed]
  • Goldberg RB, Mellies MJ, Sacks FM, Moyé LA, Howard BV, Howard WJ, Davis BR, Cole TG, Pfeffer MA, Braunwald E. Cardiovascular events and their reduction with pravastatin in diabetic and glucose-intolerant myocardial infarction survivors with average cholesterol levels: subgroup analyses in the cholesterol and recurrent events (CARE) trial. The Care Investigators. Circulation. 1998 Dec 8;98(23):2513–2519. [PubMed]
  • Haffner SM, Alexander CM, Cook TJ, Boccuzzi SJ, Musliner TA, Pedersen TR, Kjekshus J, Pyörälä K. Reduced coronary events in simvastatin-treated patients with coronary heart disease and diabetes or impaired fasting glucose levels: subgroup analyses in the Scandinavian Simvastatin Survival Study. Arch Intern Med. 1999 Dec 13;159(22):2661–2667. [PubMed]
  • Collins Rory, Armitage Jane, Parish Sarah, Sleigh Peter, Peto Richard. MRC/BHF Heart Protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial. Lancet. 2003 Jun 14;361(9374):2005–2016. [PubMed]
  • Sattar Naveed, Gaw Allan, Scherbakova Olga, Ford Ian, O'Reilly Denis St J, Haffner Steven M, Isles Chris, Macfarlane Peter W, Packard Chris J, Cobbe Stuart M, et al. Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation. 2003 Jul 29;108(4):414–419. [PubMed]
  • Tatò F, Vega GL, Grundy SM. Effects of crystalline nicotinic acid-induced hepatic dysfunction on serum low-density lipoprotein cholesterol and lecithin cholesteryl acyl transferase. Am J Cardiol. 1998 Mar 15;81(6):805–807. [PubMed]
  • Karpe Fredrik, Frayn Keith N. The nicotinic acid receptor--a new mechanism for an old drug. Lancet. 2004 Jun 5;363(9424):1892–1894. [PubMed]
  • Rubic Tina, Trottmann Matthias, Lorenz Reinhard L. Stimulation of CD36 and the key effector of reverse cholesterol transport ATP-binding cassette A1 in monocytoid cells by niacin. Biochem Pharmacol. 2004 Feb 1;67(3):411–419. [PubMed]
  • Staels B, Auwerx J. Regulation of apo A-I gene expression by fibrates. Atherosclerosis. 1998 Apr;137 (Suppl):S19–S23. [PubMed]
  • Staels B, Dallongeville J, Auwerx J, Schoonjans K, Leitersdorf E, Fruchart JC. Mechanism of action of fibrates on lipid and lipoprotein metabolism. Circulation. 1998 Nov 10;98(19):2088–2093. [PubMed]
  • Gervois P, Torra IP, Fruchart JC, Staels B. Regulation of lipid and lipoprotein metabolism by PPAR activators. Clin Chem Lab Med. 2000 Jan;38(1):3–11. [PubMed]
  • Chinetti G, Gbaguidi FG, Griglio S, Mallat Z, Antonucci M, Poulain P, Chapman J, Fruchart JC, Tedgui A, Najib-Fruchart J, et al. CLA-1/SR-BI is expressed in atherosclerotic lesion macrophages and regulated by activators of peroxisome proliferator-activated receptors. Circulation. 2000 May 23;101(20):2411–2417. [PubMed]
  • Martin G, Duez H, Blanquart C, Berezowski V, Poulain P, Fruchart JC, Najib-Fruchart J, Glineur C, Staels B. Statin-induced inhibition of the Rho-signaling pathway activates PPARalpha and induces HDL apoA-I. J Clin Invest. 2001 Jun;107(11):1423–1432. [PMC free article] [PubMed]
  • Brousseau Margaret E, Schaefer Ernst J, Wolfe Megan L, Bloedon LeAnne T, Digenio Andres G, Clark Ronald W, Mancuso James P, Rader Daniel J. Effects of an inhibitor of cholesteryl ester transfer protein on HDL cholesterol. N Engl J Med. 2004 Apr 8;350(15):1505–1515. [PubMed]
  • de Grooth Greetje J, Kuivenhoven Jan Albert, Stalenhoef Anton F H, de Graaf Jacqueline, Zwinderman Aeilko H, Posma Jan L, van Tol Arie, Kastelein John J P. Efficacy and safety of a novel cholesteryl ester transfer protein inhibitor, JTT-705, in humans: a randomized phase II dose-response study. Circulation. 2002 May 7;105(18):2159–2165. [PubMed]
  • Guyton JR. Combination drug therapy for combined hyperlipidemia. Curr Cardiol Rep. 1999 Sep;1(3):244–250. [PubMed]
  • Streja Dan. Combination therapy for the treatment of dyslipidemia. Curr Opin Investig Drugs. 2004 Mar;5(3):306–312. [PubMed]
  • Vega Gloria Lena, Ma Patrick T S, Cater Nilo B, Filipchuk Neil, Meguro Shinichi, Garcia-Garcia Ana Barbara, Grundy Scott M. Effects of adding fenofibrate (200 mg/day) to simvastatin (10 mg/day) in patients with combined hyperlipidemia and metabolic syndrome. Am J Cardiol. 2003 Apr 15;91(8):956–960. [PubMed]
  • Pauciullo P, Borgnino C, Paoletti R, Mariani M, Mancini M. Efficacy and safety of a combination of fluvastatin and bezafibrate in patients with mixed hyperlipidaemia (FACT study). Atherosclerosis. 2000 Jun;150(2):429–436. [PubMed]
  • Shek A, Ferrill MJ. Statin-fibrate combination therapy. Ann Pharmacother. 2001 Jul-Aug;35(7-8):908–917. [PubMed]
  • Wierzbicki AS, Mikhailidis DP, Wray R, Schacter M, Cramb R, Simpson WG, Byrne CB. Statin-fibrate combination: therapy for hyperlipidemia: a review. Curr Med Res Opin. 2003;19(3):155–168. [PubMed]

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